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目的评价不同全乳腺放射治疗技术的剂量学优缺点。方法选取乳腺癌保乳术后患者10例,均为女性,年龄25～58岁,中位年龄42岁。用常规切线野、野中野调强、多野调强3种技术设计全乳腺放射治疗计划并进行剂量学对比。结果与常规切线野计划比较,野中野调强计划99%靶区体积含盖剂量从(4640±72)cGy增加到(4753±25)cGy;剂量不均匀指数从1.104±0.017下降到1.060±0.008。常规切线野计划与野中野调强计划在危及器官受量上的差异无统计学意义。野中野调强计划与多野调强计划在靶区剂量分布上的差异无统计学意义;与野中野调强计划比较,多野调强计划中心脏接受高于10Gy剂量的体积(V10)从(13.0±8.5)%增加到(53.3±22.7)%;同侧肺的V10从(25.2±3.4)%增加到(42.7±3.7)%;对侧乳腺、对侧肺、非特异正常组织的V5分别从(1.9±3.1)%增加到(32.6±2.3)%、从0到(18.5±8.3)%、从(9.9±1.0)%到(32.1±3.6)%。结论野中野调强技术较常规切线野技术明显改善靶区剂量分布;在此基础上多野调强技术未能明显进一步改善靶区剂量,但增加正常组织照射。
Objective To evaluate the advantages and disadvantages of dosimetry in different whole breast radiotherapy techniques. Methods Ten cases of breast cancer after breast-conserving surgery were selected, all female, aged from 25 to 58 years, with a median age of 42 years. With the conventional tangential field, field Nakano strong, multi-field intensity of three kinds of technology design full breast radiotherapy plan and dose contrast. Results Compared with the conventional tangential field plan, 99.0% of the targeted volume of the Nakano-Iwanaka Intensified Program increased from 4640 ± 72 cGy to 4,753 ± 25 cGy, and the inhomogeneous index decreased from 1.104 ± 0.017 to 1.060 ± 0.008 . There was no significant difference between the routine tangential field plan and the Yezhongye strengthening plan in endangering organs. There was no significant difference in target dose distribution between Nakamoto Iwaya plan and MISHIKA plan. Compared with Nakano schedule, the volume of heart that received more than 10Gy dose (V10) from (13.0 ±) V5 increased from (25.2 ± 3.4)% to (42.7 ± 3.7)% in the ipsilateral lung; V5 increased from 8.5% to 53.3 ± 22.7% 1.9 ± 3.1% to 32.6 ± 2.3% from 0 to 18.5 ± 8.3% from 9.9 ± 1.0% to 32.1 ± 3.6%, respectively. Conclusion Compared with conventional tangent field technology, tonight field technique of wild-field enhancement significantly improved the target dose distribution. Based on this, the multi-field intensity-enhanced technique failed to significantly improve the target dose but increased the normal tissue irradiation.